İbrahim Batmaz

Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life.

Background The aim of this study was to evaluate sleep quality and the related variables in patients with rheumatoid arthritis (RA). Methods Ninety-four patients diagnosed with RA and fifty two healthy controls were enrolled in the study. Disease activity was assessed through the Disease Activity Score (DAS) 28 scale. All patients were assessed using the Rheumatoid Arthritis Quality of Life and Health Assessment Questionnaire scales, together with the Beck Depression Inventory. Radiological damage was calculated with the modified Larsen method. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of the sleep disturbance. Results The patients with RA had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance domains and the total PSQI score compared to the healthy control group. According to the results of Spearman’s analysis, there was a significantly correlation between the age, disease activity, CRP, pain, fatigue, depression, functional disability, quality of life, radiological damage, menopause status, duration of morning stiffness, ESR levels and the sleep disturbance. The logistic regression analysis indicated that depression and DAS 28 scores were predictors for poor sleep quality. Conclusion The sleep quality is disturbed in patients with RA. The poor sleep quality is especially associated with the disease activity and depression.

Serum prolidase enzyme activity and oxidative status in patients with fibromyalgia

Abstract Objective This study was performed to investigate serum prolidase enzyme activity and oxidative stress in patients diagnosed with fibromyalgia (FM). Methods The study population consisted of 40 patients with a previous diagnosis of FM and 30 healthy subjects. We measured serum prolidase enzyme activity, total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), and paraoxonase-1 (PON-1) levels. Results On average, FM patients were diagnosed within 3.2 years of symptom onset, and patients had a mean of 14 tender points. There were no significant differences between patients and controls in age, body mass index, serum TAS, or PON-1 levels. However, patients with FM demonstrated higher serum prolidase activity, TOS, and OSI than the control group. Serum prolidase activity was positively correlated with serum TOS, OSI, and visual analog scale pain and fatigue scores. No correlation was found between serum prolidase activity and FM duration or the average number of tender points. Discussion Our results demonstrate a previously unreported association between serum prolidase enzyme activity and FM. Increased prolidase activity may contribute to the pathogenesis of FM, and measuring serum prolidase enzyme activity may be a useful FM biomarker.

The Relationship of Metabolic Syndrome With Disease Activity and the Functional Status in Patients With Rheumatoid Arthritis

Background The aim of this study is to investigate the frequency of metabolic syndrome (MS) in patients with rheumatoid arthritis (RA) and to determine the relationship between the clinical and laboratory parameters of RA and the components of the metabolic syndrome (MS). Methods Fifty-four patients with RA and 52 healthy individuals were enrolled in this study. The diagnosis of rheumatoid arthritis was based on the American College of Rheumatology criteria and the diagnosis of the metabolic syndrome was made according to the criteria set out in the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). The functional status and disease activity were also recorded in patients with RA. Results MS was diagnosed in 42.6% of the patients with RA and in 9.6% of the healthy controls. The systolic and diastolic blood pressure values were observed to be significantly higher in the patients with RA in comparison to the controls. Also, the frequency of MS was higher in the inferior functional group in relation to the higher functional group. A positive correlation was observed between the DAS28 scores and hypertension in patients with RA. Conclusions In this study, MS was more frequently detected in the patients with RA compared to the control group. Also, an inferior functional status in RA was also found to be associated with the presence of MS. Thus, the presence of MS in patients with RA may be associated with a higher cardiovascular risk.

Efficacy of Pulsed and Continuous Therapeutic Ultrasound in Myofascial Pain Syndrome: A Randomized Controlled Study.

ObjectivesThis study aimed to compare continuous and pulsed ultrasound therapy with sham ultrasound in terms of pain, severity of muscle spasm, function, depression, and quality of life in patients with myofascial pain syndrome. DesignPatients were randomly divided into three groups, including the continuous ultrasound group (3 MHz, 1 W/cm2, n = 20), the pulsed ultrasound group (3 MHz, 1 W/cm2, 1:1 ratio, n = 20), and control group (sham, n = 20). The primary outcome measures were severity of pain at rest and during activity (visual analog scale, 0–10 cm). The secondary outcome measures were function (Neck Pain and Disability Scale), depressive mood (Beck Depression Scale), and quality of life (Nottingham Health Profile). All evaluations were performed at baseline, after treatment, and at the 6th and 12th wks. ResultsAll three groups had significant improvements in all of the pain scores, the severity of muscle spasms, function assessments, and certain subparameters of the quality of life scale (P < 0.05). The continuous ultrasound group had significantly greater improvements in pain at rest (P < 0.05). However, no statistically significant differences were observed in the other parameters (P > 0.05). ConclusionsContinuous ultrasound therapy is more efficient in reducing pain at rest for myofascial pain syndrome patients than is sham or pulsed ultrasound therapy.

Sleep quality in patients with psoriatic arthritis

The purpose of this study was to determine the effects of psoriatic arthritis (PsA) on sleep quality and investigate the association between sleep quality and clinical parameters of PsA, quality of life and psychological state in patients with PsA.

Education and Visual Information Improves Effectiveness of Ultrasound-Guided Local Injections on Shoulder Pain and Associated Anxiety Level: A Randomized Controlled Study.

ObjectiveLocal injections are widely used in patients with a painful shoulder. The aim of this study was to evaluate the possible impact of patients’ visual information on the effectiveness of ultrasound (US)-guided local injections on anxiety levels and shoulder pain. DesignA total of 151 patients, scheduled for local injection owing to shoulder pain, were randomly assigned into two groups in a consecutive order. Patients in group I (n = 72) were provided information related to US findings and allowed to watch the procedures from the monitor, whereas patients in group II (n = 79) received the injection only without any collaboration. Data were collected from both groups immediately before and after injections through visual analog scale and questionnaire (the State-Trait Anxiety Inventory [STAI] forms 1 and 2). ResultsUS-guided local injections provided significant improvement of anxiety and pain in both groups, irrespective of providing visual information. Group I and group II comparisons with respect to the visual analog scale, STAI 1, and STAI 2 yielded significant difference only for postinjection STAI 2 in group I (P = 0.006). Intragroup comparisons revealed significant differences between preinjection and postinjection values (group I: visual analog scale, P = 0.001; STAI form 1, P = 0.001; STAI form 2, P = 0.002; group II: visual analog scale, P = 0.001; STAI form 1, P = 0.002; STAI form 2, P = 0.042). There was no significant difference between the groups in terms of postinjection satisfaction levels from the procedures (P = 0.824). ConclusionsPerforming US-guided shoulder injections with patient visual information provides positive contributions to coping with pain and anxiety. In particular, the patient collaboration–based US-guided injections have positive consequences on patients’ long-standing “trait-anxiety” levels.

The impact of ankylosing spondylitis on female sexual functions.

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables, psychological status and the quality of life on the female patients’ sexual function measured according to the Female Sexual Function Index (FSFI). Thirty-seven sexually active female AS patients and 33 healthy controls were enroled in this study. Their demographic data were evaluated and the generalised pain in patients with AS was assessed according to the visual analogue scale (0–100 mm). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. In comparison to the healthy control group, patients with AS had significantly lower scores in each of the five domains of the FSFI except for the pain domain (P<0.05). The disease activity, functional status, quality of life, radiological score and CRP levels were negatively correlated with the FSFI (P<0.05). No significant correlation was observed with the disease duration, smoking status, depression, anxiety, pain and ESR when the total scores and the scores from the domains of the FSFI were compared. The sexual function is impaired in female patients with AS. This impairment in the sexual function is especially related to the functional status and disease activity among the clinical and laboratory parameters.

Relationship between serum leptin level and disease activity in patients with systemic sclerosis

To determine the relationship between serum leptin levels and disease activity in systemic sclerosis (SSc). A total of 60 subjects (30 controls and 30 patients) were included. The inflammatory markers and leptin levels were evaluated and body mass index (BMI) was measured for both groups. The assessment of the skin involvement was performed based on the modified Rodnan skin score (mRSS). Disease activity was evaluated according to the Valentini scleroderma disease activity index. There was a significant difference between the patient and control groups in terms of BMI (p < 0.05); however there was no difference with regards to age and gender (p > 0.05). Valentini scores and mRSS were determined to be significantly higher in active patients (n = 14) than in inactive patients (n = 16) (p < 0.05). No significant difference was determined between groups in terms of leptin levels (p > 0.05). However, leptin levels were significantly lower in active patients than in inactive patients (p < 0.05). We found a significant positive correlation between serum leptin and BMI (p < 0.05), and leptin and serum C3 levels (p < 0.05); no relationship was detected between leptin and other parameters. Leptin can be used as an activity marker in SSc. Further studies, including larger series, should be carried out to clarify this relationship.

A case of brucellar spondylodiscitis involving the cervical spine.

We have presented a patient of 71-year-age with brucellar spondylodiscitis, involving the cervical spine, especially the C3-C4 segment. The patient had painful percussion of the cervical spine and passive mobilization of the neck, decreased range of motion, and cervical paravertebral tenderness; but no abnormalities observed on neurological examination. Wright agglutination test for brucella was positive at 1/320. Cervical localization for brucellar spondylodiscitis is an unusual case and should be detected and treated as early as possible. In endemic regions, spinal involvement of brucellosis should be considered in cases with fever, neck and low back pain.

Evaluation of the Anterior Segment Parameters of the Patients with Scleroderma

ABSTRACT Purpose: To evaluate corneal parameters of scleroderma (SC) patients by Pentacam-HR. Methods: Twenty-two eyes of 22 SC patients and 33 eyes of 33 control subjects were enrolled. All participants underwent Pentacam (Pentacam-HR, Oculus, Germany) evaluation. Both SC and control groups were divided into two subgroups as dry eye (DE) (Schirmer test with topical anesthesia (STA) ˂5 mm) and without DE (STA ˃5 mm). Results: Pachymetric measurements and mean corneal volume (CV) were significantly lower in the SC group than in the control group (p<0.001). Pachymetric measurements and CV of SC patients with DE were significantly lower than all the other subgroups. Control subgroups with or without DE were similar in pachymetric measurements and CV. Conclusions: The results suggest that SC patients have thinner corneas compared with control subjects. Additionally, coexistence of DE seems to have an additional impact in the thinning of cornea in SC patients.